Healthcare Provider Details

I. General information

NPI: 1285746636
Provider Name (Legal Business Name): CANCER CENTER OF HAWAII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 LILIHA ST LEVEL B-2
HONOLULU HI
96817-1600
US

IV. Provider business mailing address

2226 LILIHA ST LEVEL B-2
HONOLULU HI
96817-1600
US

V. Phone/Fax

Practice location:
  • Phone: 808-547-6881
  • Fax: 808-547-6583
Mailing address:
  • Phone: 808-547-6881
  • Fax: 808-547-6583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License NumberRT0007
License Number StateHI

VIII. Authorized Official

Name: VINCENT C BROWN
Title or Position: MANAGER/MEDICAL DIRECTOR
Credential: M.D.
Phone: 808-547-6881